![]() Additionally, low risk reactions such as pain at injection site, redness, and local reactions also have been reported. While this list is not inclusive, the most common high-risk complaints and diagnoses associated with vaccine administration in the past have been Guillain-Barré syndrome, febrile convulsions, seizures, anaphylaxis, and meningitis/encephalitis. Passive surveillance relies on healthcare providers and vaccinated persons to report side effects after vaccine administration. Reporting of “adverse event following immunization” (AEFIs) are usually based on a passive surveillance system. The prudent clinician will consider vaccine side effects as a trigger for potential serious complications and initiate an appropriate workup, while the impudent one will simply label the patient as having a vaccine side effect. Elderly and those with risk factors present with high-risk complaints. While it may be easy to dismiss these complaints as vaccine related, the fact that nearly 18% were admitted with a median and mean length of stay longer than a brief period of observation, disputes that assertion. As a result, many of these patients receive full workups. While this data encompasses a short time frame, it demonstrates that COVID-19 vaccine reactions may present with high-risk chief complaints to the ED. The top 3 chief complaints on arrival were shortness of breath (12.6%), chest pain (10.8%), and allergic reaction (10.5%). Hospital length of stay for admitted patients was a mean of 3.88 and a median of 2.72 days. Eighty-one percent were discharged and 17.9% were admitted. In the workup, 70.3% had labs drawn, 61.6% were given IV medications, 45.8% obtained x-ray imaging, and 20.3% patients had CT scans obtained. The mean acuity on the Emergency Severity Index (ESI), was 3. Of these patients, 85% presented during the day and evening hours and the mean age at time of encounter was 57.5 years. Those with ICD-10 codes related to COVID-19 vaccine reaction were extracted and descriptive statistics performed in Microsoft Excel (Redmond WA).ģ80 encounters had adverse reaction to COVID vaccine listed as one of their ED diagnosis ( Table 1 We reviewed the discharge and admit diagnosis of all patients seen between Januand Maacross 20 EDs in our healthcare system from the electronic medical record (Epic, Verona, WA). We aim to describe the incidence of emergency department (ED) visits secondary to COVID-19 vaccine reactions within a large healthcare system. ![]() To date there have been no studies regarding ED visits related to the COVID-19 Vaccine. ![]() In addition, many infectious disease experts believe that COVID-19 vaccines will require an annual booster as immunity may wane over time and the virus mutates. These side effects appear more prevalent than those of the seasonal influenza vaccine and have drawn more attention. Other reported side effects of mRNA vaccines are fevers, myalgias, nausea, vomiting and flu like illnesses. The Centers for Disease Control and Prevention has recommended that the mRNA SARS-CoV-2 vaccines should not be administered to individuals with a known history of a severe allergic reaction to any component of the vaccine ( 3). In a recent published letter, anaphylaxis to mRNA COVID vaccines was cited to occur in 2.5 to 11.1 cases per million doses ( 2). ![]() Side-effects from the COVID-19 vaccine are well-documented. Of those that are vaccinated, 66.6% are ≥65 years of age ( 1). As of April 23, 2021, nearly 27.5% of Americans have been vaccinated against COVID-19. ![]() To combat the devastating consequences of the COVID-19 pandemic, vaccines were developed using mRNA carriers and rapidly distributed. ![]()
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